<b>Relationship Between Daily Step Count and Fear of Falling in Older Adults with Type 2 Diabetes</b>

Background: Older adults with type 2 diabetes mellitus are vulnerable to reduced mobility, impaired balance confidence, and fear of falling, which may contribute to activity restriction and functional decline. Daily step count provides an objective and clinically interpretable measure of ambulatory physical activity in this population. Objective: To determine the relationship between daily step count and fear of falling among older adults with type 2 diabetes mellitus.  Methods: A cross-sectional correlational study was conducted among 100 older adults with type 2 diabetes mellitus recruited from hospital and community settings. Demographic and clinical data were collected using a structured questionnaire. Daily step count was measured using a waist-worn pedometer over three consecutive days, and the average daily step count was calculated. Fear of falling was assessed using the Falls Efficacy Scale-International. Descriptive statistics summarized participant characteristics and activity distribution, while correlation analysis examined the association between daily step count and fear of falling.  Results: The mean age of participants was 72.2 ± 6.27 years. Most participants were male (71.0%), and low ambulatory activity was common, with 67.0% recording fewer than 3000 steps/day and 92.0% remaining below 6000 steps/day. Daily step count showed a statistically significant negative correlation with fear of falling (r = −0.267, p = 0.007), indicating higher fear among participants with lower step counts.  Conclusion: Lower daily step count was significantly associated with greater fear of falling among older adults with type 2 diabetes mellitus. Objective step-count monitoring may help identify individuals at risk of fear-related activity restriction and guide rehabilitation strategies to improve mobility and confidence